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January 14, 2009 -- Incensed at an online review she considers libelous, Yvonne Wong, D.D.S., of Foster City, CA, is suing the parents of a young patient. The case could set a precedent in the fast-growing area of Internet commentary on healthcare practitioners.

“It would behoove them to consider a settlement and an apology. I think they owe her that after the way they desecrated her for no reason.”
— Attorney John Ter Beek

"I'm seeking major damages," said Dr. Wong's attorney, John Ter Beek, of San Leandro, CA. "It would behoove them to consider a settlement and an apology. I think they owe her that after the way they desecrated her for no reason."

The review appeared on Yelp.com, an online forum specializing in reviews of small businesses such as restaurants, auto repair shops -- and sometimes dentists.

The reviewer -- identified only as "T.J." -- has already modified the review. But, Ter Beek said, "the damage has been done."

Dr. Wong contends that the review defames her by implying that she didn't inform the boy's parents about alternatives to the use of amalgam and nitrous oxide and didn't spot other cavities needing treatment.
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Those are assertions of fact rather than opinion, Ter Beek said, a key distinction in determining whether a public comment is libel.

In fact, Dr. Wong has the signature of one of the parents -- whom Ter Beek identified as Tai Jing and Jia Ma of Los Altos, CA -- on an informed consent form that mentions the mercury in the restoration, he said. "So that's kind of a lie."

Ter Beek said the review implied that Dr. Wong had used general anesthesia, when she had only used nitrous oxide.

Finally, he said that Dr. Wong had been willing to treat the patient's other cavities, but the patient's parents had insisted on weekend appointments, which Dr. Wong tries to avoid, in part because her full staff is not available then.

Tai Jing, Jia Ma, and Dr. Wong could not be reached for comment. Dr. Wong's reviewer has now edited the review to say, simply, "Dr Chui, who shares the same office with Dr Yvonne Wong, is very nice." Both the updated and original reviews give Dr. Wong one out of a possible five stars.

However, several other Yelpers have chimed in to accuse Dr. Wong of attempting to squelch the reviewer's free speech.

Honest and truthful

Yelp spokesperson Stephanie Ichinose said the company does not take reviews down from the site on the basis of disputes over accuracy. "We encourage reviewers to be honest and truthful," she said. But "we can't make a judgment call either way."

Instead, the site offers business owners -- including dentists -- a new tool for contacting reviewers directly.

"We encourage business owners to have a conversation with the reviewer," Ichinose said. "In many cases, if that's done in the right tone, owners and clients are often able to come to an understanding."

In addition, she noted, Yelp launched a new feature, "About this Business," in which dentists can describe specialties, insurance plans, and anything else they want their patients to know.

In this case, Yelp contacted the reviewers, but only to refer them to California Anti-SLAPP Project, a nonprofit organization that fights "strategic lawsuits against public participation," which it defines as "lawsuits filed against people or organizations because they have exercised their right to petition the government or speak out on public issues."

Ter Beek originally named Yelp as a plaintiff in the lawsuit, but then found out that under section 230 of the U.S. Communications Decency Act, "No provider or user of an interactive computer service shall be treated as the publisher or speaker of any information provided by another information content provider."

As a result, "We're probably going to drop the case against Yelp," Ter Beek said.

The case is not the first to test how far Yelp reviewers can go in critiquing their healthcare providers, according to the San Francisco Chronicle. On January 9, a reviewer settled a lawsuit brought by a chiropractor he had reviewed, the newspaper reported. Terms were not disclosed.